c/o Sean Donnelly
11 Olive St
Newburyport, MA 01950-2313
Daytime Phone: Date of Birth: Age on race date:
What is your New Year's Resolution?
Please check gender and event you are entering
Gender: M F 5K 10K
Must Be Read and Signed Before Mailing:
I know that running a road race is a potentially hazardous activity.
I should not enter and run unless I am medically able and properly trained.
I assume all risks associated with running including but not limited
to falls, contact with other participants, the effects of the road and
traffic; all such risks being known by me. Having read this waiver and
knowing these facts, I, for myself and my heirs and assigns, and anyone
else entitled to act on my behalf, do waive and release Prize4Life and
the the City of Lowell and all sponsors, their directors and officers,
from all claims of liabilities of any kind or nature whatsoever arising
out of my voluntary participation in this race, even though that liability
may arise out of negligence or carelessness on the part of the persons
named in this waiver.
_______________________________ ___________ _____________________________________
Signature Date Parent's Signature if under 18
for your support.